I. 17. CDRL_32122_efa_signed.pdf

DD FORM 1423-2, FEB 2001 Previous editions are obsolete Page 1 of 2

CONTRACT DATA REQUIREMENTS LIST

(2 Data Items)

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 110 hrs per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, & completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington, Headquarters Services, Directorate for Information Operations and Reports, 1213 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT/ATTACHMENT NO. C. CATEGORY

All A TDP: TM: OTHER: See Blk 16

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

P/N 5385-0101 and P/N 1002-0074 N6660422P0294 / 1300990355 Kinematics & Controls Corporation

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A001 CERTIFICATE OF COMPLIANCE

4. AUTHORITY (Data Acquisition Doc. No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MISC-81356A N/A NUWCDIVNPT Code 4512

7. DD250 REQ

9. DIST STATEMENT REQ.

D

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT See Block 16 See Block 16 See Block 16 a. ADDRESSEE b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION DRAFT FINAL

N/A N/A N/A REQ REPRO

16. REMARKS Code 4512 0 1 0

Block C Category (Other): MISC

Block 4: Contractor format is acceptable.

Block 9: See Block 16 Distribution Statement Addendum

Blks 10-12: At the time of material delivery, a Certificate of Compliance shall be submitted to NUWCDIVNPT for each of the two part numbers being ordered.

15. TOTAL 0 1 0

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Doc. No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD250 REQ 9. DIST STATEMENT REQ. 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION DRAFT FINAL

REQ REPRO

16. REMARKS

***INTENTIONALLY LEFT BLANK***

15. TOTAL

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Robert M. Waleyko 2/2/2022 Emma Anderson 3/21/2022

DD FORM 1423-1, ADDENDUM Page 2 of 2

DD FORM 1423, CONTRACT DATA REQUIREMENTS LIST

BLOCK 16 ADDENDUM

PR TBD

BLOCK 9: The following information is specifically included in amplification of the Block 9 Distribution

Statement shown on each DD FORM 1423. Distribution Statement paragraphs are in addition to

CLASSIFICATION markings of the data.

DISTRIBUTION D: Distribution authorized to Department of Defense and U.S. DoD contractors only; Critical

Technology. Dated when data generated. Other request for this document shall be referred to Naval Undersea

Warfare Center Division, Newport, RI, Code 4512.

The following "EXPORT CONTROL WARNING NOTICE" must be used in conjunction with DISTRIBUTION

STATEMENTS identified in all CDRL Items. WARNING: This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C. Sec. 2751 et seq.) or the Export Administration Act of

1979, as amended, Title 50, U.S.C., App. 2401 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.